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Opinion >  Guest Opinion

AMA should stop trying to limit nurse practitioners

A committee of the American Medical Association is threatening the ability of nurse practitioners to fulfill their critical role in modern health care.

The committee’s Resolution 214, adopted in mid-November, calls for PR campaigns and legislation to oppose state laws allowing nurse practitioners to work independently – what’s known as “full scope of practice.”

It’s astonishing to me that we’re still having this conversation in 2017.

For one thing, nurse practitioners already can practice independently in more than 20 states, including Washington, Idaho and Oregon. That means they can order tests, diagnose illness, manage treatments and prescribe medications.

Plus, multiple studies, including randomized clinical trials, show that patient outcomes among people seeing nurse practitioners for their primary care were equivalent and in some studies more effective than outcomes among those seeing physicians. A review of research in 2015 found that APRNs in primary care “provided care that was in some ways different from care provided by physicians, but with comparable quality and at equal or lower cost.”

Nurse practitioners are quickly becoming the backbone of primary care in this country, especially in rural and low-income areas. There’s a physician shortage in America that’s going to get worse, and the problem is especially acute in places like Eastern Washington. Did you know that 13 of the 20 counties that make up Eastern Washington are considered by the federal government to be either partially or fully “medically underserved” for primary care? Nurse practitioners are part of the solution to that problem.

In 1893, Lillian Wald, a nurse, originated the field of public health, which means caring for people in their communities. She founded the Henry Street Settlement in New York to tend to people in desperate circumstances in the tenements of the Lower East Side. The role of nurse practitioner emerged in the 1960s to address the primary care needs of people who were not receiving adequate health care.

Nurse practitioners have either a master’s or doctorate degree and advanced clinical training. They’re licensed as Advanced Practice Registered Nurses (APRN) and certified by a commission-approved certifying body. At the WSU College of Nursing, we educate family nurse practitioners and psychiatric/mental health nurse practitioners.

Keep in mind, acceptance of nurse practitioners is widespread beyond the American Medical Association. Both the Department of Veterans Affairs and the National Academies of Sciences, Engineering, and Medicine support full practice authority for nurse practitioners to provide primary care. And Merritt Hawkins, a leading physician recruiting and consulting firm, noted in a 2016 report that nurse practitioners were among the most-recruited jobs that year. NPs “when used appropriately, supplement the physician workforce and allow physicians to practice at the top of their training,” the report said.

The American Medical Association needs to stop wasting time on this protectionist, regressive effort. Instead, why not put that energy to use partnering with nurse practitioners on interprofessional efforts to improve health care quality and access for all?

Joyce Griffin-Sobel, Ph.D., has led the WSU College of Nursing since 2016. She previously served as dean at State University of New York Upstate Medical University and has extensive experience in oncology nursing.


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